Tag Archives: department of veterans affairs

Study suggests veterans are more likely to survive after receiving emergency care at VA hospitals

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Photo by Pavel Danilyuk via Pexels.

A new study provides a rare example of something akin to a head-to-head comparison of the quality of care delivered at hospitals run by the Veterans Administration (VA) versus those outside this federal system.

In this case, the advantage appears to go to the VA on a measure of how likely patients were to remain alive within a month of being treated with emergency care.

This study focuses on veterans aged 65 years or older who were enrolled in both the Veterans Health Administration and the Medicare program, reported David C. Chan, M.D., Ph.D., of Stanford University and co-authors in a paper published by the BMJ on Feb. 16. (This paper is available under open-access terms, making it freely accessible to the public.)

Chan and co-authors focused on cases of medical crises involving emergency ambulance rides with lights and sirens that originated from 911 dispatch calls. They used data from the VA, Medicare and Social Security Administration to track what happened to these veterans in the 30 days following these episodes. They also honed in on cases involving veterans who lived within 20 miles of at least one VA hospital and at least one other kind of hospital. 

There were 9.32 deaths per 100 patients in those seen at the VA hospitals, Chan and co-authors wrote. They reported a 95% confidence interval range of 9.15 to 9.50 for this figure. (For more on understanding confidence intervals, check the glossary in AHCJ’s medical studies section.) ​​For the veterans taken to other hospitals, Chan and co-authors estimated a rate of 11.67 deaths per 100 patients. They cited a 95% confidence interval range of 11.58 to 11.76 for this group. 

These differences translate into an adjusted mortality rate after 30 days that was 20.1% lower among veterans taken to VA hospitals by ambulances than among veterans taken to other hospitals, Chan and co-authors wrote.

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Kerry Dooley Young (@kdooleyyoung) is AHCJ's core topic leader on patient safety. She has written extensively about the Food and Drug Administration, medical research, health policy and quality measurements. Her work has appeared in Medscape Medical News, Congressional Quarterly/CQ Roll Call and Bloomberg News.

VA centers in 30 states, D.C. used recalled wipes

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JoNel Aleccia of MSNBC.com continues her reporting on tainted and recalled alcohol prep pads, finding that “A quarter of the nation’s Veterans Health Administration medical centers and the agency’s outpatient mail-order pharmacy used recalled alcohol prep pads and other products …”

The FDA has identified problems with contamination and sterilization at the plant where the products were manufactured and hundreds of millions of products were recalled because of the threat of bacterial contamination.

The VA says “38 of the country’s 152 major veterans medical centers in 30 states and the District of Columbia removed recalled wipes, pads and other products from use” and “products were removed from the Consolidated Mail Outpatient Pharmacy, which provides more than 97.4 million prescriptions a year to veterans.”

Previously, the FDA the company that manufactured the wipes refused to identify which hospitals used the products, but Aleccia has obtained and published a list of the affected VA facilities.

Recalled povidone iodine prep pads from the same company also have been included in first aid kits intended for animals, such as this equine first-aid kit.

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Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Spreadsheet lists malpractice claims against VA

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In its “FOIA Friday” feature, the Project On Government Oversight reveals a spreadsheet (XLS format) of claims against the Department of Veterans Affairs, including thousands related to medical malpractice.

The spreadsheet lists administrative claims, the first step in the VA’s process for filing claims.

Nick Schwellenbach explains more about the data:

The data provided has details on over 12,000 claims against the VA from 1989 to November 2008, although the data appears largely incomplete for the first several years. Not all of the claims are medical malpractice-related, but several thousand are. There are fields for the VA facility involved, the date the claim was received, the date of the last tort status (where the claim is in the administrative process), the date of that status, alleged negligence descriptions (none exist for non-medical malpractice tort cases), and amount paid out, if any. The spreadsheet is over two years old, so the latest tort status field may be out-of-date for many of these claims.

The spreadsheet includes 16 cases in which more than $1 million was paid out. The descriptions of the allegations are pretty vague but those 16 cases include:

  • Failure To Obtain Consent or /Lack Of Informed Consent; Improper Technique; Improper Performance; Improper Management; Delay In Diagnosis; Failure To Treat; Failure To Order Appropriate Medication; Failure To Monitor; Failure To Diagnose (i.e., Concluding That Patient Has No Disease or Condit[ion)]
  • Failure To Respond To Patient
  • Surgical or Other Foreign Body Retained
  • Unnecessary Procedure; Intubation Problem; Improperly Performed Test; Improper Management

It’s worth noting that another recent “FOIA Friday” also was related to health. It was a letter sent by the National Institutes of Health to Emory University “after the media exposed Dr. Zachary Stowe’s cozy financial relationship with GlaxoSmithKline (GSK) while also receiving NIH grants to study antidepressants like GSK’s Paxil in pregnant women.”

Pia Christensen (@AHCJ_Pia) is the managing editor/online services for AHCJ. She manages the content and development of healthjournalism.org, coordinates AHCJ's social media efforts and edits and manages production of association guides, programs and newsletters.

Story on soldiers’ aches and pains wins member a Mid-America Emmy

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A story inspired by a session at Health Journalism 2009 earned member Meryl Lin McKean the 2010 Emmy for Health/Science News at the Mid-America Emmy Awards this year. McKean is the medical reporter at WDAF-Kansas City. Her story looked beyond casualty rates to the everyday aches and pains that come as a result of active military service in Iraq and Afghanistan. The video is no longer available, but the accompanying text demonstrates the scope and severity of such problems.

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Soldiers return to a border checkpoint in the Khowst province of Afghanistan. Photo by The U.S. Army via Flickr

A V.A. report found that nearly half of the returning vets from Iraq and Afghanistan have bone, joint or tissue injuries. At Kansas City’s V.A. Medical Center, 17% of the vets seen in the new post-deployment clinic have those injuries. That’s still far higher than in non-vets.

“This age group between 18 and 30 — you might expect five percent at the most,” says Bob Fletcher, V. A. Physician’s Assistant.

Fletcher says the problems are clearly related to the combat load. And the problems for many vets will continue. Those problems include include arthritis pain and stiffness, the inability to hold certain jobs that require much movement, and possible dependence on pain medication.

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.

PTSD or personality disorder? It matters to soldiers

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The AP’s Anne Flaherty has put together a story that illuminates the Army’s refusal to admit that it could have misdiagnosed (and discharged) hundreds of soldiers who may have had PTSD or traumatic brain injury instead of a personality disorder. Keep in mind that a discharge for “personality disorder” means no veterans’ benefits and a lifetime of stigma. A diagnosis of PTSD or injury, on the other hand, means treatment will be covered by the government.

dentistPhoto by isafmedia via Flickr

The Army, for its part, has decided there’s nothing unusual about the following chain of events (taken from Flaherty’s story):

  1. The Army “discharged about a 1,000 soldiers a year between 2005 and 2007 for having a personality disorder.”
  2. In 2007, The Nation‘s Joshua Kors writes a cover story exposing the Army’s apparent habit of diagnosing soldiers with a personality disorder instead of considering the possibility of PTSD or traumatic brain injury.
  3. Soon after, “the Defense Department changed its policy and began requiring a top-level review of each case to ensure post-traumatic stress or a brain injury wasn’t the underlying cause.”
  4. Sure enough, “the annual number of personality disorder cases dropped by 75 percent.”
  5. At the same time, the number of post-traumatic stress disorder cases has soared. By 2008, more than 14,000 soldiers had been diagnosed with PTSD — twice as many as two years before.
  6. Army officials “reviewed the paperwork of all deployed soldiers dismissed with a personality disorder between 2001 and 2006” and said they “did not find evidence that soldiers with PTSD had been inappropriately discharged with personality disorder.”

Andrew Van Dam of The Wall Street Journal previously worked at the AHCJ offices while earning his master’s degree at the Missouri School of Journalism.